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Illinois rates for HCPCS 99495

Transitional care management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge, At least moderate level of medical decision making during the service period, Face-to-face visit, within 14 calendar days of discharge

Facilitymedian $191 · 10th–90th $115–$4270%10%10th90th$191Professionalmedian $182 · 10th–90th $112–$3800%10%10th90th$182$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $371.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$28.84 / $346.74 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $173.78 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $239.88 / $512.86
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$144.54 / $208.93 / $263.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $331.13
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $229.09 / $457.09
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $275.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $316.23 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $190.55 / $288.40